{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:10:44Z","timestamp":1787008244364,"version":"build-2736575974"},"reference-count":39,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Technology &amp; Therapeutics"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Diabetes mellitus is associated with significant health care resource utilization (HCRU), partly due to acute complications, including diabetic ketoacidosis (DKA) and hypoglycemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To investigate glycated hemoglobin (HbA1c) levels and HCRU before and after adoption of FreeStyle Libre Systems (FSL) in people with diabetes on multiple daily injections of insulin (MDI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective longitudinal study used administrative health data in Ontario, Canada, housed at IC\/ES. The cohort comprised people with diabetes on MDI with a first FSL claim between September 16, 2019, and August 31, 2020 (index date), who remained on FSL for 24 months. HCRU (emergency department [ED] visits and hospitalization) was measured for 12 months before the index date and the last 12 months of follow-up. HbA1c data were taken from the last tests in each period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Mean HbA1c was statistically significantly reduced after FSL among people with type 1 diabetes mellitus (T1DM;\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 10,510; age &lt;25 years, \u22120.8%; 25\u201365 years, \u22120.5%; &gt;65 years, \u22120.1%; all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001) or type 2 diabetes mellitus (T2DM;\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 12,668; age \u226465 years, \u22120.6%; &gt;65 years, \u22120.3%; both\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001). Overall HCRU was statistically significantly reduced in the T1DM subgroups aged &lt;25 and 25\u201365 years (ED visits only) and both T2DM age subgroups, with some subgroups having statistically significant reductions in DKA- or hypoglycemia-associated HCRU.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Among people with T1DM or T2DM on MDI, HbA1c was statistically significantly reduced after FSL, with statistically significant reductions in HCRU in some subgroups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/dia.2024.0609","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T12:02:46Z","timestamp":1739966566000},"page":"449-459","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["FRONTIER\u2014FreeStyle Libre System Use in Ontario Among People with Diabetes Mellitus in the IC\/ES Database\u2014Evidence from Real-World Practice: Patients Using Intensive Insulin"],"prefix":"10.1177","volume":"27","author":[{"given":"Alexandria","family":"Ratzki-Leewing","sequence":"first","affiliation":[{"name":"Western University, London, Canada."},{"name":"University of Maryland Institute for Health Computing, North Bethesda, Maryland, USA."},{"name":"Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stewart B.","family":"Harris","sequence":"additional","affiliation":[{"name":"Western University, London, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4706-5170","authenticated-orcid":false,"given":"R\u00e9mi","family":"Rabasa-Lhoret","sequence":"additional","affiliation":[{"name":"Montreal Clinical Research Institute, Montreal, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeesha","family":"Poon","sequence":"additional","affiliation":[{"name":"Abbott Diabetes Care, Mississauga, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-1962"},{"key":"e_1_3_7_3_2","unstructured":"Diabetes Canada. New data shows diabetes rates and economic burden on families continue to rise in Ontario. 2019. Available from: https:\/\/www.diabetes.ca\/media-room\/press-releases\/new-data-shows-diabetes-rates-and-economic-burden-on-families-continue-to-rise-in-ontario [Last accessed: June11 2024]."},{"key":"e_1_3_7_4_2","unstructured":"Health Canada. Universal Access to Diabetes Medications and Diabetes Device Fund for Devices and Supplies. 2024. Available from: https:\/\/www.canada.ca\/en\/health-canada\/news\/2024\/02\/universal-access-to-diabetes-medications-and-diabetes-device-fund-for-devices-and-supplies.html [Last accessed: October5 2024]."},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-2449"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.19099"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-S006"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0034"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2022.0271"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2016-000316"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjd.2022.05.010"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2015.0417"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2021-002590"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-019-00720-0"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-016-0223-6"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2019-001115"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.1210\/jendso\/bvab013"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2021-002580"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-S007"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eprac.2023.02.001"},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjd.2021.07.003"},{"key":"e_1_3_7_22_2","unstructured":"Diabetes Canada. Coverage of Glucose Monitoring Devices. 2024. Available from: https:\/\/www.diabetes.ca\/getmedia\/0170dc2c-0efe-4543-97b9-7b4563bb845f\/Glucose_Monitoring_Devices_EN_2024.pdf [Last accessed: October25 2024]."},{"key":"e_1_3_7_23_2","unstructured":"Diabetes Canada. Diabetes in Ontario. 2023. Available from: https:\/\/www.diabetes.ca\/DiabetesCanadaWebsite\/media\/Advocacy-and-Policy\/Backgrounder\/2023_Backgrounder_Ontario.pdf [Last accessed: June11 2024]."},{"key":"e_1_3_7_24_2","unstructured":"Diabetes Canada. Snapshot of Diabetes in Canada. 2023. Available from: https:\/\/www.diabetes.ca\/DiabetesCanadaWebsite\/media\/Advocacy-and-Policy\/Backgrounder\/2023_Backgrounder_Canada_English.pdf [Last accessed: June11 2024]."},{"key":"e_1_3_7_25_2","unstructured":"IC\/ES. About IC\/ES Data. 2024. Available from: https:\/\/www.ices.on.ca\/about-ices-data\/ [Last accessed: April11 2024]."},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-024-01535-4"},{"key":"e_1_3_7_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjd.2022.04.009"},{"key":"e_1_3_7_28_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.25.3.512"},{"key":"e_1_3_7_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjd.2023.04.006"},{"key":"e_1_3_7_30_2","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20190213"},{"key":"e_1_3_7_31_2","unstructured":"Wodchis WP Bushmeneva K Nikitovic M et al. Guidelines on Person-Level Costing Using Administrative Databases in Ontario. Toronto; 2013. Available from: https:\/\/tspace.library.utoronto.ca\/handle\/1807\/87373 [Last accessed: October30 2024]."},{"key":"e_1_3_7_32_2","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14294"},{"key":"e_1_3_7_33_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-1690"},{"key":"e_1_3_7_34_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.6530"},{"key":"e_1_3_7_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-024-02851-8"},{"key":"e_1_3_7_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajmo.2022.100008"},{"key":"e_1_3_7_37_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2019-001007"},{"issue":"1","key":"e_1_3_7_38_2","first-page":"14","article-title":"Diabetes Canada 2018 clinical practice guidelines: Key messages for family physicians caring for patients living with type 2 diabetes","volume":"65","author":"Ivers NM","year":"2019","unstructured":"Ivers NM, , Jiang M, , Alloo J, et al. Diabetes Canada 2018 clinical practice guidelines: Key messages for family physicians caring for patients living with type 2 diabetes. 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